The Comprehensive Glucose Pentagon: A Glucose-Centric Composite Metric for Assessing Glycemic Control in Persons With Diabetes
| Autor: | Thorsten Siegmund, Andreas Thomas, Boyi Jiang, Robert A. Vigersky, Mcmahon Chantal M, John H. Shin |
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| Rok vydání: | 2017 |
| Předmět: |
Blood Glucose
medicine.medical_specialty Endocrinology Diabetes and Metabolism Biomedical Engineering 030209 endocrinology & metabolism Bioengineering Hypoglycemia 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Diabetes Mellitus Internal Medicine Humans Hypoglycemic Agents Insulin Medicine 030212 general & internal medicine Glycemic Glycated Hemoglobin business.industry Continuous glucose monitoring Blood Glucose Self-Monitoring Original Articles medicine.disease Surgery Emergency medicine Metric (unit) business Algorithms |
| Zdroj: | Journal of Diabetes Science and Technology. 12:114-123 |
| ISSN: | 1932-2968 |
| DOI: | 10.1177/1932296817718561 |
| Popis: | Composite metrics have the potential to provide more complete and clinically useful information about glycemic control than traditional individual metrics such as hemoglobin A1C, %/time/area under curve of hypoglycemia and hyperglycemia.Using five key metrics that are derived from continuous glucose monitoring, we developed a new, multicomponent composite metric, the Comprehensive Glucose Pentagon (CGP) that demonstrates glycemic control both numerically and visually. Two of its axes are composite metrics-the intensity of hypoglycemia and intensity of hyperglycemia. This approach eliminates the use of the surrogate marker, hemoglobin A1C (A1C), and replaces it with glucose-centric metrics.We reanalyzed the data from two randomized control trials, the STAR 3 and ASPIRE In-Home studies using the CGP. It provided new insights into the effect of sensor-augmented pumping (SAP) in the STAR 3 trial and sensor-integrated pumping with low-glucose threshold suspend (SIP+TS) in the ASPIRE In-Home trial.The CGP has the potential to enable health care providers, investigators and patients to better understand the components of glycemic control and the effect of various interventions on the individual elements of that control. This can be done on a daily, weekly, or monthly basis. It also allows direct comparison of the effects on different interventions among clinical trials which is not possible using A1C alone. This new composite metric approach requires validation to determine if it provides a better predictor of long-term outcomes than A1C and/or better predictor of severe hypoglycemia than the low blood glucose index (LBGI). |
| Databáze: | OpenAIRE |
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